Motor Regression is loss of gross motor and/or fine motor skills. The disorders which present with motor regression may initially manifest also as delay / stagnation of development. Problem in diagnosing regression may arise because in many. Inborn Errors of Metabolism regression is episodic, worsening with acute illnesses and many acute or chronic severe illnesses are also associated with loss of motor skills. The exact duration after which regression in milestones after an acute illness, is to be taken as significant has not been defined anywhere but any child whose motor abilities don't improve commensurate with improvement in his / her general condition and / or who has disproportionate changes in tone or loss of skills in association with minor illnesses should be assessed for these disorders and kept under observation.

Causes of Motor regression

The causes of Motor regression can be classified according to the 'site of lesion in the Nervous System' & also according to the 'Age at presentation'.

Table 1 Etiology of Motor regression according to Anatomical site of lesion

But any child whose motor abilities don't improve commensurate with improvement in his / her general condition and / or who has disproportionate changes in tone or loss of skills in association with minor illnesses should be assessed for these disorders and kept under observation.

Causes of Motor regression according to Age

Child <3 years of age
Group 1: Progressive walking difficulties related to lesions of central and peripheral motor system-Spastic paraplegia and/or peripheral neuropathy

Family History - A detailed family history should be taken for similar / related illnesses e.g. CP, Unexplained deaths, Myopathies, Retinitis Pigmentosa). A 3 degree pedigree chart should also be made.

History of Environmental Exposure to Lead and other toxins should also be elicited.

Investigations

Investigations are planned keeping in mind our probable diagnosis. It is very important to investigate specially for treatable causes.

Blood Investigations -

Hemogram - It may show basophilic stippling, Inclusions in WBCs, Acanthocytosis.

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